Surgical procedures and devices are known for creating transosseous tunnels for attachment of soft tissues, such as tendon and ligaments to bone. Both artificial and natural materials are attached to these soft tissues to repair them, and surgical procedures may move soft tissues from one location to another to repair a damaged, torn or severed tendons or ligaments.
U.S. Pat. Pub. 2008/0188936 and WO 2008/097901 disclose details of rotator cuff repair. The human shoulder is a complex system of hard and soft tissues that exhibits extraordinary mobility using coordinated activation of a variety of muscles, simultaneously. A conventional arthroscopic repair of a torn supraspinatus tendon is disclosed in the background of the publication, reporting that 20-60% of rotator cuff repairs fail. The publication discloses the dilemma with surgery of this type. Any artificial addition to the tissues that takes up too much stress on living tissues can lead to atrophy of the living tissues. In order to heal properly, living tissues must be exposed to a certain level of stress that is within a nominal range for healing. These ranges are known in the art, but devices and techniques that provide optimal healing are not available. Bioabsorbable materials are disclosed both in the background and as an embodiment of the publication's invention. The publication teaches away from making tension members from non-absorbable materials; however, the absorbable materials of the patch and tension members may be reinforced by non-absorbable materials, such as by including non-absorbable fibers in a patch material or tension members, and may be attached by bone anchors. The publication teaches providing coatings on its medical devices, providing biologically active agents for improving healing, for example.
U.S. Pat. No. 5,268,001 discloses a bone fastener for fixing either a suture or a rivet within a predrilled bone hole. The background of this issued patent summarizes the variety of materials and types of bone anchors historically available for using in anchoring soft tissues to bones, either as a rivet or as a suture anchor. The patent discloses a hand held means 70, in FIGS. 3.1 and 3.2 of the patent, which is useful in setting an anchor within an annular portion, fixing the anchor and annular portion within a pre-drilled hole in a bone.
U.S. Pat. No. 7,651,495 discloses a method and apparatus for preventing migration of sutures through transosseous tunnels. Its improved method for attaching soft tissues to bone passes a suture through a transosseous tunnel and uses the suture to affix the soft tissue to the bone. The improved apparatus is an eyelet, which is placed into an end of the bone opposite of the soft tissue and through which the suture passes. The eyelet may be threaded, interference fit or pressure fit using a two piece insertion/expandable member, with the expandable member anchoring the insertion member within the pre-drilled hole through the bone. The patent discloses in its background that it is known that transosseous tunnels are the gold standard of rotator cuff repair, but migration of sutures through the bone itself is a significant complication, particularly in older patients. The patent discloses a known attachment mechanism using plate-like augmentation to reinforce the bone, teaches significant disadvantages of this technique and teaches the advantages of its eyelet approach to preventing migration of the suture through degradation under the force of the sutures on the bone. U.S. Pat. No. 5,725,529 discloses another bone fastener having similar characteristics to other disclosed bone fasteners.
U.S. Pat. Pub. 2010/0191248 discloses an arthroscopic tunnel guide for rotator cuff repair. Its tunnel guide provides a transosseous tunnel having a fixed, non-zero radius of curvature using a bone cutting instrument. This disclosure provides a tool and drill guide that provides a curvature to a transosseous tunnel drilled arthroscopically, allowing arthroscopic surgeons use of a portion of the humeral head that was previously only available by open surgery.
U.S. Pat. Pub. 2010/0191247 discloses another apparatus for drilling a transosseous tunnel. The reference teaches that the drill bit tip acts as an anchor at the far cortex distal from the surface of the humeral head adjacent to the soft tissues, when the anchor is detached from the drill bit, at the distal end of the transosseous tunnel formed by the drill bit tip. The applicant believes that there is a concern with the use of this device in the way described in the publication, which introduces a risk of possible axillary nerve injury during the described procedure, which drills to the inferior-medial aspect of the humeral head.
All of the listed patents and publications in this background are incorporated by reference in their entirety herein for the purposes of providing background and materials selection for biocompatible materials. None of the listed patents provide for a time-saving method to prevent the migration of sutures through transosseous tunnels, while repairing damaged tissues and promoting healing.